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Interview with Ruth Charles, Secretary of the Irish Food Allergy Network (IFAN)

How did the Irish Food Allergy Network (IFAN) come about?

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Posted on: May 12, 2014     Publication: Nutricia News Spring 2014 print page

Interview with Ruth Charles, Secretary of the Irish Food Allergy Network (IFAN)

How did the Irish Food Allergy Network (IFAN) come about?
I noticed increasing numbers of infants and toddlers presenting with suspected food allergy at my HSE based dietetic clinic from 2000, a time when there was a massive “black hole” in national allergy services. Families were struggling to cope not to mention me as a DIetitian. The associated burden of care and quality of life issues for affected families were huge and significant.

There were very limited clinicians and allied health staff trained and competent in Paediatric Allergy resulting in faulty diagnosis and over restricted diets. Allergy “testing” was erratic and poorly interpreted. This had to change. It was very timely that Professor Hourihane moved to Cork in 2005 and Dr. Fitzsimons moved to Louth in 2009. Both are trained Paediatric Allergists although not employed by the HSE in that capacity. Their return to Ireland brought knowledge, skills and competencies at a level that facilitated the seeds of IFAN to be sown.

Who initiated the group? / who was the driving force behind it?
I was. In October 2010 I had started to compile a database of interested stakeholders from a variety of backgrounds both clinical and non clinical. I had also been in discussion with Professor Hourihane and Dr. Fitzsimons about addressing the gap in allergy services nationwide with the result that in July 2011, IFAN was born. I act as Secretary/Administrator.

Who’s currently involved?
IFAN is only as good as its membership and we are lucky to have a network of multidisciplinary members representative of parents, dietitians, doctors, nurses, pharmacists, schools, industry, government and non-government agencies and the food sector with good working links established. IFAN is chaired by Jonathan Hourihane, Professor of Paediatrics and Child Health at UCC and Cork University Hospital and supported in this role by Dr. John Fitzsimons, Consultant Paediatric Allergist, Drogheda.

IFAN is delighted to welcome Dr. Aideen Byrne Consultant Paediatric Allergist at Tallaght and Crumlin Hospitals on board-a fantastic addition. A Core Writing Group produced Irish specific resources (available on www.ifan.ie) and included those above plus Dr. Sean O’Callaghan from the ICGP, Dr. Theresa Mc Sweeney AMO from the Institute of Public Health, Dr. Imelda Lambert Consultant Paediatrician from the Faculty at RCPI, Dearbhla Hunt, Teresa Kelly, Deborah Griffin and Caroline O’Connor from the INDI and Deirdre Daly, Nurse Specialist.

Why is there a need for a group such as IFAN?
At this time, services for adults and children with food allergies continue to be extremely under resourced.

The long term aim of IFAN is to work towards highlighting the need for and the development of a fully resourced national allergy service for patients and health care staff.

What is the ethos of IFAN?
Allergy service provision is a cheap, low tech, ambulatory specialty that’s in high demand nationwide. IFAN’s philosophy is that an integrated management approach, when and where it’s needed for children and families living with allergy; offering diagnosis, management, guidance, advice and support, is best.

Why do you think allergy services have been ignored for so long in Ireland?
The Health Service in Ireland has not recognised allergic disease as a priority despite documented increases in these conditions (food allergy, asthma, eczema and hay fever) over the recent decades and public demand for services. Despite a Comhairle na nOispideal report and recommendation in 2000 for national immunology services, allergy has not been adequately addressed as a specialty focused on the holistic needs of the allergic child. There is no fully resourced service as yet.

The first HSE Paediatric Allergist in Ireland was appointed in 2013, 13 years after the Comhairle recommendations. Meanwhile allergic children usually first present to health care services in the community who are not trained to recognise and deal with the spectrum of allergy.

Describe an ideal allergy service and what it looks like?
Any service must be patient and family centred. Community based health care staff including Dietitians are best placed to identify, diagnose and manage most cases. We need much greater education, training and support for this in the community.

Allergy aware clinicians and teams including Dietitians are needed in regional hospitals, trained, resourced and equipped to manage cases up to and including food challenges.

Development of tertiary care services is required to manage complex cases and immunotherapy.

Where would IFAN like to be in 5 years’ time?
Resources permitting, we hope to be going strong and achieving our yearly stated aims! We’ve achieved a lot in a small timeframe but we have a lot more to do.

Professor Hourihane likes to describe how if you want to eat an elephant you should do so small piece by small piece by small piece, so we hope to keep eating our way through!

What activities have IFAN been involved in during 2013?
Last year was dominated by the launch of the website containing resources adapted specifically for Food Allergy in the Irish healthcare environment. These include best practice guidelines for:
• Diagnosing and managing food allergy in the Community and in Hospitals
• 4 Food specific care pathways for:
Cows’ milk protein allergy , Egg allergy, Peanut allergy and Tree nut allergy

IFAN went on the road and brought these resources to over 600 multidisciplinary attendees in 12 venues across Ireland. 23% of INDI members attended.

IFAN also issued a joint statement on “testing” for food allergy & food intolerance and a statement on fatal food anaphylaxis.

It’s important to recognise that IFAN’s activities to date (and going forward) could not have been achieved without the collaboration and support of industry-including Nutricia, which IFAN acknowledges gratefully.

What’s next for IFAN /Plans for 2014?
There is so much that could be tackled but we’ve decided that the focus for 2014 is to audit the level of change in knowledge and practice among road show attendees and increasing awareness and education in Primary Care. We also want to engage more with parents and affected families-they have a powerful voice and deserve to be heard.

Can people get involved?
Absolutely! The network has over 600 members but we are always looking for more. Sincere thanks are due to all the Dietitians and others who helped out with administration at the regional meetings. We also appreciate all Dietitian’s comments and feedback on the website content.

You can contact IFAN via the “contact” page at www.ifan.ie or email .(JavaScript must be enabled to view this email address). If you want to come on board, please do. Be prepared to get actively involved and do let us know how you think you can contribute.

We encourage you to review the website, use the resources and pass them on to parents and colleagues.

Ruth Charles is a Consultant Dietitian in Paediatrics, a member of both the INDI and INDANA-the International Network for Dietitians and Nutritionists in Allergy. She has a Certifi cate of Advanced Study in Paediatric Allergy from Imperial College London and is a volunteer skills provider to Anaphylaxis Ireland.

Ruth Charles - IFAN

Tags: allergy



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